My doctor suggested I take anti-seizure medication for my migraines, but it's not approved for that. He says it's safe and effective. What's your take?

In the United States, 4.02 billion prescriptions are written annually, and more than 20 percent are to treat diseases or conditions for which the drugs are not specifically Food and Drug Administration-approved. That's called off-label use, and it is perfectly legal. In fact, more than half of all uses of cancer drugs are prescribed off-label, and that's even OK with health insurance companies.

But pharmaceutical companies can't advertise or have their reps suggest to doctors that their medications are effective for off-label use. This is true even if the off-label benefits have been demonstrated in peer-reviewed, scientific studies.

The good news: This keeps companies from pushing medications for uses that have not been verified as safe, and it protects you. For example, one superlarge pharma company was recently fined $700 million for advocating that their drug -- approved only for use during chemo -- be used by cancer patients who were not on chemo. They'd been warned not to do that by the FDA, because the pharma company's own study had found generalized use increased serious risks, and other drugs worked just as well for patients not on chemo.

The not-so-good news: There's no fast-track for FDA-approved drugs to get a thumbs up for alternate uses. That means people who could be helped by a novel application may not be.

But that may be changing: A court overturned the conviction of a pharmaceutical representative for advocating off-label use of a drug, saying the conviction violated the defendant's right of free speech, and the government sought to prosecute the defendant solely on the basis of his speech.

However this shakes out, when you get a prescription from any doctor, ask if it's being prescribed for the approved use. If it's not, ask how long it has been used for your particular off-label application; if any studies testing its safety and effectiveness for that application have been done; and what the potential side effects are when used to treat your condition.

In your case, anti-seizure medications are used often to treat migraine when other medications have not provided relief. And stay tuned; there's a new nerve-stimulation treatment that looks like it might prevent and stop migraine attacks.

Health tip of the week:Fibromyalgia in men a real disorder

Michael Hastings may not be a name that's on the tip of your tongue (he had a small recurring part on "The West Wing" as Captain Mike), but that obscurity is far less painful to him than his diagnosis of fibromyalgia, a neurological pain disorder that forced his retirement from acting.

If he's the only guy you've heard of who has fibro, you're not alone. Some health-insurance companies refuse to accept the diagnosis; some doctors won't diagnose it; and some men don't believe they have it. No wonder a new study reveals that 20 times more men are dealing with this mysterious condition than have been diagnosed.

Why is this? First, nine out of 10 diagnosed are women; second, because of hormone differences, men's symptoms typically are different in duration, location and degree of pain than women's; third, men are reluctant to go see a doctor for hard-to-pin-down aches and pains; and fourth, ads targeting lack of energy imply that men have "low testosterone." Wrong diagnosis.

So, guys, if you have chronic pain not caused by injury, arthritis or another disorder and you're fatigued despite sleep, here's what we suggest:

• Find a doctor who will take your complaints seriously; the National Fibromyalgia Association can help.

The medical community finally is getting hip to how many men suffer needlessly with this condition; let them help you.

Dr. Michael Roizen is chief wellness officer at the Cleveland Clinic and co-founder and chairman of the RealAge Scientific Advisory Board. Dr. Mehmet Oz
is a professor and vice chairman of surgery at Columbia University, as
well as medical director of the Integrated Medicine Center and director
of the Heart Institute at New York Presbyterian/Columbia Medical Center.
To submit questions and find ways to grow younger and healthier, go to RealAge.com.

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